Average payments are $58,000 for small providers, $289,000 for medium providers, and $1.7 million for larger providers. The U.S. Department of Health and Human Services, through the Health Resources and Services Administration (HRSA), said it’s distributing about $9 billion in Provider Relief Fund payments to providers, with a particular focus on smaller providers. This is […]
The package includes three ICD-10-CM and seven procedure codes. The Centers for Disease Control and Prevention (CDC) and the Centers for Medicare & Medicaid Services (CMS) have both stated that in April 2022, we will have three new ICD-10-CM codes and seven new procedure codes for COVID-19 therapeutics and vaccines. You may recall that in […]
The cost to appeal is worth the claim reimbursement and modification of payer behavior. As we approach 2022, one of our new year’s resolutions should be to do what’s necessary to decrease denials. We know that payers and external auditors took a break during the pandemic, but now it’s open season for audits and denials. […]
Taya Moheiser, CMPE, CMOM, owner of ITS Healthcare, and Kem Tolliver, CMPE, CPC, CMOM, president of Medical Revenue Cycle Specialists to share the top trends they’re following right now. KEY TAKEAWAYS Mental health billing will continue to evolve. Billing directly to Medicare for physician assistants will take center stage. Be sure to educate your […]
The news coincided with the sudden worldwide emergence of the new omicron COVID-19 variant. An influx of cash couldn’t have come at a better time for the nation’s rural healthcare system. The U.S. Department of Health and Human Services (HHS) last week announced that the Health Resources and Services Administration (HRSA) has begun distributing $7.5 […]
Cluster coding is a new feature for coding professionals. The World Health Organization (WHO) began developing the International Classification of Diseases, Eleventh Version (ICD-11), in 2007, and first released a preliminary version for evaluation and testing in 2016 – ironically, just one year after the U.S. finally adopted a clinical modification of the WHO’s ICD-10 […]
CMS dramatically increases financial penalties for noncompliance with hospital price transparency rules. On Nov. 2, 2021, the Centers for Medicare & Medicaid Services (CMS) released the calendar year (CY) 2022 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System final rule, finalizing payment rates and policy changes affecting Medicare services furnished […]
Mississippi’s Medicaid program ranks poorly for its access to and quality of care, but Medicaid expansion could increase healthcare coverage along with lowering state Medicaid spending. Mississippi could achieve lower state Medicaid spending over the course of five years by expanding its Medicaid program with the American Rescue Plan boost to federal matching, a […]
Take 5 to read up on recent coding and billing news. There are plenty of coding updates in November, including those made to certain Medicare policies. Payment thresholds for physical, occupational, and speech-language pathology are also posted for the 2022 calendar year, as are Medicare cost sharing amounts. And HCPCS Level II code set updates […]
In first-quarter 2022, the HCPCS Level II code set will get a refresh with several new, revised, and deleted codes. According to the Centers for Medicare & Medicaid Services (CMS), there are: 155 new codes, 63 revised codes, and 48 deleted codes. Medical coders and billers: Familiarize yourself now with these code changes so you’re […]